Post-ACA, more hospitals explore shared decision-making

More providers are open to shared decision-making after the implementation of the Affordable Care Act, which provides incentives for the practice, according to Kaiser Health News.

Historically, there has been reluctance among healthcare providers to cede control of the care process to patients without medical training and who may have obtained their information from dubious sources. Patients, meanwhile, are often not used to speaking up during the care process and tend to assume the doctor knows best. Recently, however, KHN reports that providers in several states, such as Massachusetts, Washington and Minnesota, have implemented programs to further two-way doctor-patient communication, according to the article.

For example, UC San Francisco (UCSF) distributes DVDs, pamphlets or links to patients explaining available treatment options, and doctors explain the benefits and risks of such options during appointments as well as soliciting information about patients' goals and priorities. The article said UCSF assigns college students or recent graduates to help patients compose lists of questions for their doctors, record the visits and take notes for the patients, ensuring they have an objective account of a visit that may leave them nervous or anxious, such as a cancer diagnosis.

"It's a massive cultural change," Glyn Elwyn, who researches shared decision-making at The Dartmouth Institute for Health Policy and Clinical Practice, told Kaiser Health News. "It's going from 'I'm the expert, take my recommendation' to 'I am going to inform you and respect your wishes.'"

In an increasingly value-based healthcare industry, shared decision-making is an essential feature for hospitals hoping to make it to the "second curve" of healthcare, according to Paul Keckley, managing director at the Navigant Center for Healthcare Research and Policy Analysis, FierceHealthcare previously reported. Healthcare experts say mandatory remedial patient engagement training for doctors could improve patient engagement and encourage shared decision-making.

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